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Psychosomatic Medicine 24:257-266 (1962)
© 1962 American Psychosomatic Society

Specific Attitudes in Initial Interviews with Patients Having Different "Psychosomatic" Diseases

DAVID T. GRAHAM M.D.1, RICHARD M. LUNDY Ph.D.1, LORNA S. BENJAMIN Ph.D.1, J D KABLER M.D.1, WILLIAM C. LEWIS M.D.1, NANCY O. KUNISH B.A.,1, and FRANCES K. GRAHAM Ph.D.1

1 Departments of Medicine, Psychology, Psychiatry, and Pediatrics, University of Wisconsin, Madison, Wisc.

A specificity-of-attitude hypothesis, proposed by Grace and Graham,3 stated that there is a specific relation between the attitude towards a stressful stimulus and the disease which occurs in response to the stimulus. Two interview studies with hospitalized patients investigated whether attitudes predicted to be associated with diseases were more applicable to patients having the disease in question than to patients who did not have the disease. There were 16 patients with eight diseases in the first study, and 20 patients' with ten diseases in the second study. Half of the patients, matched for disease, were interviewed by a psychologist unfamiliar with the specific predictions of the hypothesis under investigation. The recorded interviews were edited to remove references identifying diseases and were submitted to two medical and two nonmedical judges. Judges selected from a list of 18 previously described attitudes the three attitudes most similar to those expressed in each interview. They also ranked all 18 attitudes in the order of their applicability to the patient.

The percentage of predicted choices was significantly greater than the expected percentage in both studies, and in both the blind and the nonblind interviews. The average of correctly predicted choices in the two studies were 28 per cent and 45 per cent for. the blind interviews, and 38 per cent and 62 per cent for the nonblind interviews.

Three judges chose the predicted attitudes significantly often from the interviews conducted blind and all four judges chose the predicted attitudes significantly often from the nonblind interviews. Judges showed significant agreement with one another and the nonmedical judges did as well as the medical.

A particular attitude was ranked lower, i.e., was judged more applicable than others, when patients had the associated disease than when they had other diseases. The ranks for predicted attitude-disease associations were significantly lower in the blind interviews of the second study and in the nonblind interviews of both studies.

It was concluded that different psychosomatic diseases are associated with different attitudes. The association was demonstrated even when a naive interviewer and naive judges were employed.

Submitted on May 2, 1961




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